Code No. 503.7E1
REPORT OF STUDENT DISCLOSURE OF IDENTITY
Dear (Parent/Guardian)_____________________________,
This letter is to inform you that your student (student’s name listed on registration)_____________________________
has made a request of a licensed employee to (check all that apply):
_________make an accommodation that is intended to affirm the student’s gender identity as follows:
_________use a name, pronoun or gender identity that is different from the name, pronoun and/or gender identity listed on the student’s school registration forms. The name, pronoun, or gender identity requested is
If you would like to amend the student’s registration paperwork to permit the student’s requested accommodation and/or include the use of the above-referenced name/pronoun/gender identity, please complete the attached form and return it to the district administration office.
Sincerely,
__________________________________________ _____________________
Administrator Date